Our study demonstrated that both IRT and US were applicable tools for detecting wrist arthritis.

Osteoporosis is a common problem in thalassemics. As the most affected bone is spinal vertebrae, theoretically, it should have the greatest risk of fracture. However, vertebral fracture (VF) in thalassemics was rarely reported. Screening for asymptomatic VF in thalassemics has not been reported. We, therefore, evaluated prevalence of VF in adolescents and young adults with thalassemia. A total of 150 patients with thalassemia, aged 10 years and older were enrolled. Lateral thoracolumbar spine radiography was evaluated. Twenty patients (13%) had VF and 6 of 20 (30%) had multiple VFs. The 2 most common sites of VF were lumbar 1 and thoracic 12 vertebrae. Comparing with the group without VF, thalassemics with VF were older, had more severe degree of thalassemia, history of splenectomy and previous non-VF, more iron chelation use, and longer duration of blood transfusion, but had lower pretransfused hematocrit. Multivariate analysis revealed 2 predictive factors for VF, having severe thalassemia and aged 20 years or older (odds ratio 5.7 and 5.0, respectively). In conclusion, unrecognized asymptomatic VF in thalassemics was not uncommon. Risk factors associated with VF included severe thalassemia and age 20 years or older. Screening for VF in the high-risk patient should be considered.

Background Growth impairment is the most common complication in patients with childhood-onset systemic lupus erythematosus (cSLE). There are limited data on risk factors affecting growth development in Asian patients with cSLE. This study aimed to determine the predictors of growth impairment in such patients. Methods All SLE patients aged < 15 years diagnosed in Ramathibodi Hospital between 2006 and 2016 were enrolled in a retrospective cohort study. Baseline characteristics, including height, weight, clinical manifestations, disease activity score, and medications, were reviewed from medical records from the time at diagnosis to achievement of final adult height (FAH). Age at menarche in girls, adult voice appearance in boys, and parental height were collected by interview. Parent-adjusted FAH (PaFAH) Z-score was calculated as the difference between FAH Z-score for chronological age of the patients and their mid parental height-Z score. The patients were classified into two groups: (1) normal growth (PaFAH Z-score ≥ − 1.5, 2) growth impairment (PaFAH Z-score < − 1.5). Descriptive statistics and logistic regression analysis were used to analyze the data. Results Of 106 cSLE patients, 19 (18%) were male and 87 (82%) were female. The mean age at study enrollment was 20.6 ± 3.0 years, mean age at diagnosis 12.1 ± 2.3 years, and mean age at achievement of FAH 17.5 ± 1.9 years. Growth impairment was found in 23.6% of patients (52.6% in boys and 17.2% in girls). Predictors of growth impairment were male sex, duration of disease before menarche in girls and adult voice appearance in boys, and cumulative corticosteroid dose (prednisolone equivalent) ≥230 mg/kg received before the late phase of puberty, with odds ratios of 7.07 (95%CI 2.11–23.74), 1.26 (95% CI 1.02–1.56), and 6.99 (95%CI 1.63–30.02), respectively. Conclusions One-fourth of cSLE patients developed growth impairment, which mostly affected male patients. Longer duration of disease before the late phase of puberty and corticosteroid dose ≥230 mg/kg received before the late phase of puberty were factors predictive of growth impairment.